Comorbid Insomnia and Sleep Apnea: COMISA

Abstract

The term "comorbid insomnia and sleep apnea" (COMISA) has been used to categorize the co-occurrence of the most prevalent and impacting sleep disorders. Meanwhile, both insomnia and sleep apnea have been shown to be associated with increased stress levels and cardiometabolic risk, a major cause of mortality. The better knowledge about such convergence would be critical for better understanding pathophysiological pathways and mechanisms. This article provides an overview of epidemiologic aspects, clinical findings, and mechanisms subsiding COMISA. Odontostomatological approach with mandibular advancement devices are discussed as an effective therapeutic approach in these patients.

Keywords: COMISA; Cardiometabolic risk; Comorbid insomnia; Comorbid sleep apnea; Comorbid sleep disordered breathing; Mandibular advancement devices; Stress.